Transfer of the teres minor motor branch for triceps reinnervation in tetraplegia

Case report

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In a case involving tetraplegia and paralysis of elbow extension, the authors transferred teres minor branches to the nerve of the triceps long head. Surgery was performed bilaterally 9 months after the patient sustained a spinal cord injury. Fourteen months postoperatively, elbow extension was complete (British Medical Research Council Score M4). Harvesting of the teres minor motor branch produced no deficits in shoulder function. In patients with tetraplegia, nerve transfer seems to be a promising new alternative for elbow extension reconstruction.

Abbreviations used in this paper: BMRC = British Medical Research Council; EMG = electromyography; SCI = spinal cord injury.

Article Information

Address correspondence to: Jayme A. Bertelli, M.D., Ph.D., Rua Newton Ramos 70, apto 901, Florianópolis, Santa Catarina 88015395, Brazil. email: drbertelli@gmail.com.

Please include this information when citing this paper: published online January 21, 2011; DOI: 10.3171/2010.12.JNS101519.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Skin incision in the axillary region for transfer of the teres minor motor branch to the triceps long head motor branch.

  • View in gallery

    Intraoperative view of the transfer of the teres minor (TM) motor branch to the triceps long (TL) head motor branch. Note the adequate diameter matching between the nerve stumps. Also, observe that coaptation is tension free. Ax = axillary nerve; IB = intercostobrachial nerve; LD = latissimus dorsi tendon; RN = radial nerve; TMa = teres major.

  • View in gallery

    Schematic representation of the surgical procedure. Arrowhead indicates the coaptation site of the teres minor motor branch with the triceps long head motor branch.

  • View in gallery

    Results of elbow extension reconstruction on the left side 14 months after surgery.

References

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